Journal of Oriental Neuropsychiatry (동의신경정신과학회지)

The Korean Society of Oriental Neuropsychiatry (대한한방신경정신과학회)
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A Qualitative Case Study of the Medical Doctor-Patient Therapeutic Relationship

의사-환자의 치료적 관계에 대한 질적 사례연구

  • Sung Hyun Kang (Department of Korean Neuropsychiatry Medicine, College of Korean Medicine, Wonkwang University) ;
  • Do-Eun Lee (Department of Korean Neuropsychiatry Medicine, College of Korean Medicine, Wonkwang University) ;
  • Junghyun Choi (Department of Korean Neuropsychiatry Medicine, College of Korean Medicine, Wonkwang University) ;
  • Gwang Woo Kim (Wonkwang University Jeonju Oriental Medicine Hospital) ;
  • Yeoung Su Lyu (Department of Korean Neuropsychiatry Medicine, College of Korean Medicine, Wonkwang University) ;
  • Hyung Won Kang (Department of Korean Neuropsychiatry Medicine, College of Korean Medicine, Wonkwang University) ;
  • Moon Joo Cheong (Korea Institute of Integrative Medicine, Wonkwang University Jangheung Integrative Medical Hospital)
  • 강성현 (원광대학교 한의과대학 한방신경정신과학교실) ;
  • 이도은 (원광대학교 한의과대학 한방신경정신과학교실) ;
  • 최정현 (원광대학교 한의과대학 한방신경정신과학교실) ;
  • 김광우 (원광대학교 전주한방병원) ;
  • 유영수 (원광대학교 한의과대학 한방신경정신과학교실) ;
  • 강형원 (원광대학교 한의과대학 한방신경정신과학교실) ;
  • 정문주 (원광대학교 장흥통합의료병원 대한통합의료연구원)
  • Received : 2023.09.11
  • Accepted : 2023.09.21
  • Published : 2023.09.30
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Abstract

Objectives: The purpose of this study was to identify the doctor-patient relationship perceived by doctors in clinical settings and the effect of doctor-patient relationships on treatment schemes. A qualitative case study was conducted for this purpose. Methods: In-depth interviews were conducted with five oriental medicine doctors and doctors working in clinical settings using a semi-structured questionnaire. Transcription and coding were performed to analyze the data. By analyzing each case individually through within-case analysis, we attempted to find themes that emerged from the research subjects' experiences with establishing relationships with patients. Afterward, a cross-case analysis was conducted to identify the meaning of the experiences through commonalities and differences. Results: Within-case analysis confirmed the thoughts and emotions of the research participants in recognizing, defining, and participating in doctor-patient relationships while delivering treatments. Case-to-case analysis derived two themes, seven categories, and 20 meaningful units for doctor-patient relationships. Conclusions: The study found that a doctor-patient relationship regarding patient treatment could be established based on the doctor's 'professional qualifications' and 'human qualities'. In the future, it is necessary to present an educational model for relationship-based intervention techniques and personality maturity. Follow-up research should be conducted to enable the establishment of therapeutic relationships between doctors and patients.

Keywords

Acknowledgement

This thesis is part of the Graduate School of Wonkwang University dissertation (doctorate) in 2022. This research was supported by a grant of the Korea Health Technology R&D Project through the Korea Health Industry Development Institute (KHIDI), funded by the Ministry of Health & Welfare, Republic of Korea (grant number : HI20C1951).

References

  1. Gwon BG, Kim HC. Bioethics and Law. Seoul:Ewha Womans University Press. 2005:120. 
  2. Peabody FW. The care of the patient. The Journal of American Medical Association. 1984;252:813-8.  https://doi.org/10.1001/jama.1984.03350060057032
  3. Osler W. Remarks on specialism. Boston Med Surg J. 1892;126:457-9.  https://doi.org/10.1056/NEJM189205121261901
  4. Goold S, Lipkin M. The doctor-patient relationship: challenges, opportunities, and strategies. Journal of General Internal Medicine. 1999;14:26-32.  https://doi.org/10.1046/j.1525-1497.1999.00267.x
  5. Murphy J, Chang H, Montgomery JE, Rogers WH, Safran DG. The quality of physician-patient relationships. The Journal of Family Practice. 2001;50:123-9. 
  6. Moore PJ, Adler NE, Robertson PA. Medical malpractice: the effect of doctor-patient relations on medical patient perceptions and malpractice intentions. Western Journal of Medicine. 2000;173:244. 
  7. National College of Oriental Medicine's Neuropsychiatry Textbook Compilation Committee. Korean Neuropsychiatry. 3rd rev. ed. Paju. jipmoondang. 2016:157-63. 
  8. O DI. An exploratory study on the introduction of family physician based on satisfaction survey from a customer centered care principle. Journal of the Korea AcademiaIndustrial cooperation Society. 2020;21:456-68. 
  9. Hellin T. The physician-patient relationship: recent developments and changes. Haemophilia. 2002;8:450-4.  https://doi.org/10.1046/j.1365-2516.2002.00636.x
  10. Laine C, Davidoff F. Patient-centered medicine: a professional evolution. JAMA. 1996;275:152-6.  https://doi.org/10.1001/jama.1996.03530260066035
  11. Stewart M, Brown JB, Weston WW, McWhinney IR, McWilliam CL, Freeman TR. Patient-centered medicine: transforming the clinical method. 2nd ed. London. Radcliff Medical Press. 2003. 
  12. Yu GU, Jeong JW, Kim YS, Kim HK. Understanding qualitative research methods. 2nd rev. ed. Seoul. pybook. 2018.56-9. 
  13. Lee KM, Kang JH, Lee HG. A case study on gambling addiction process in urbanizing rural area: focused on the B area in K province. Studies on Life and Culture. 2007;46:351-81. 
  14. Lee MY. A qualitative research on the experience of providing community services for social integration of North Korean migrants. Journal of Future Social Work Research. 2016;7:5-34. 
  15. Ko MY, Jang HJ, Yoon HM. A qualitative study of the experience of reflecting team members of the narrative therapy for families accused of child abuse. J Children & Righes. 2013;17:699-735. 
  16. Patton MQ. Qualitative research. In: Brian SE, David H. Encyclopedia of statistics in behavioral science. Chichester. John Wiley & Sons. 2005:1633-6. 
  17. Yin RK. Case study research design and methods. 5th ed. California. Sage. 2014:282. 
  18. Creswell JW. Research design: qualitative, quantitative, and mixed methods approaches. 3rd ed. California. Sage Publications, Inc. 2009. 
  19. Stake RE. Qualitative case studies. in: Denzin NK, Lincoln YS, eds, The Sage handbook of qualitative research. California. Sage Publications Ltd. 2005:443-66. 
  20. Hsieh HF, Shannon S. Three approaches to qualitative content analysis. qualitative health research. 2005;15:1277-88.  https://doi.org/10.1177/1049732305276687
  21. Guba EG, Lincoln YS. Fourth generation evaluation. California. Sage Publications, Inc. 1989. 
  22. Haug MR, Lavin B. Practitioner or patient-who's in charge? Journal of Health and Social Behavior. 1981;212-29. 
  23. Park CY. changing phase of the medical professionalism in the social perception and attitude toward physicians. Korean Sociological Association. 1993;27:219-43. 
  24. Kim DH. Medical communication: three function approach. Health Communication. 2006;1(1):1-6. 
  25. Kim MJ. Study on the factors influencing doctor's com - munication styles : individual characteristics and patient-centered trait. Korean Journal of Journalism & Com - munication Studies. 2009;53:146-72. 
  26. Kim BG, Lee KH. The effect of the nonverbal communication of the medical service provider on the customer orientation, customer satisfaction, long-term relationship orientation, and word of mouth intention. Journal of Marketing Studies. 2009;17:29-64. 
  27. Kim SW, Kim KH, Jang YH. The relationship between core service quality, trust, value and satisfaction in medical service. Journal of Marketing Studies. 2009;17:115-40. 
  28. Kim YK, Yu JP. A study on verbal and non-verbal communication of medical service provider. Journal of Korea Service Management Society. 2008;9:225-58.  https://doi.org/10.15706/jksms.2008.9.1.010
  29. Park YI. Institutional characteristics and typology of the doctor-patient-dialog. Text Linguistics. 2006;21:207-37. 
  30. Seo PS. The impact of doctors' communication styles on patient satisfaction: empirical examination. Korean Journal of Hospital Management. 2002;7:57-101. 
  31. Yang EB. Teaching and learning communication skills in medical education. Korean Journal of Medical Education. 2008;20:99-107.  https://doi.org/10.3946/kjme.2008.20.2.99
  32. Lee DW. A conversational analysis of 'doctor-patient' communication - in search of the interpersonal communication problems and solutions. Korean Journal of Journalism and Communication Studies. 2000;45:232-65. 
  33. Im JH, Lee KH, Beak SK. Influence of physician's com - munication style and quality, and physician-patient relationship on patient satisfaction. Korean Journal of Hospital Management. 2009;14:83-103. 
  34. Choi MI, Kim BC, Jang JY. Comparative analysis of doctor-patient perception on docotor's communication skill : coorientation model test. Journal of Public Relations. 2011;15:115-43.  https://doi.org/10.15814/JPR.2011.15.4.115
  35. Han HK, Kim JM. A study on the operation of blog as a horizontal communication channel between doctors and patients: focusing on in-depth interviews with physician bloggers. Journal of Communication Science. 2011;11:533-62. 
  36. Kim CD, Kwon KI, Han YJ, Sohn NH. The Korean counselor's factors which contribute to positive counseling outcomes. The Korea Journal of Counseling. 2008;9:961-86.  https://doi.org/10.15703/KJC.9.3.200809.961
  37. Miller SD, Duncan BL, Hubble MK. Escape from Babel : toward a unifying language for psychotherapy practice. Seoul. Hakjisa. 2009:47-52. 
  38. Jeong M. A study on the mediating effect of patient activation between trust in healthcare professionals and shared decision making in diabetic patients. Journal of the Korea Convergence Society. 202;12:361-71. 
  39. Kim J, Kim KD, Jo J, Huh J, Jung S, Lee B. Analysis of various influencing factors related to patient-dentist interaction score. The Journal of the Korean dental association. 2019;57:595-604.  https://doi.org/10.22974/JKDA.2019.57.10.005
  40. Yon MH. The influence of Carl R. rogers on the field of American psychotherapies. Journal of Human Understanding and Counseling. 2009;30:1-19. 
  41. Han ER, Kim S, Chung EK. The relationship between medical students' assessment of standardized patients and patient-physician interaction score. Korean Medical Education Review. 2019;21:150-4.  https://doi.org/10.17496/KMER.2019.21.3.150
  42. The Textbook Complication Committee of Neuropsychiatry of Oriental Medical Schools in Nation. The Neuropsychiatry of Oriental Medicine. 3rd ed. Gyung-gi Paju:Jipmoon Publishing Co. 2016:710-20.